Breast augmentation – why cost shouldn’t be the first question you ask

One of the most common questions regarding breast augmentation is "how much does it cost?" When you are looking to make a costly purchase of any kind, the cost is certainly an important factor to consider, but when your health and medical results are at stake, it shouldn't be the only one. In fact, it should be far down the list, below patient safety and the quality of the results. Cheap surgery can end up being the most expensive procedure of all.

Patient safety

Breast augmentation is real surgery, and although the complication rates are low, they are much higher in the hands of someone who isn't well-trained or who cuts corners by operating in an unaccredited facility. The most extreme is to get bargain surgery in another country without rigorous safety regulations.

Start by confirming that your surgeon is board-certified – not by just any board, but by the American Board of Plastic Surgery. This indicates that the surgeon has gone through rigorous training, extensive examination and maintenance of expertise. This training takes years, and maintaining expertise requires time, so a cost-cutting shortcut is to skip all that training and testing and to just take a weekend course. To figure this out, simply look up the surgeon you are considering on the American Society of Plastic Surgeons (ASPS) website. All members of ASPS are certified by the American Board of Plastic Surgery and are in good standing.

Where your surgery is performed is as important is who is performing the surgery. Confirm that your surgeon operates in an accredited operating room. Qualified accrediting/certifying agencies include AAAASF, AAAHC, IMQ, Medicare and the state your surgeon practices in. These agencies regularly check the facilities they accredit or certify for multiple safety features, including the physical facility, staffing, policies and procedures, emergency protocols and much more. Safety is expensive, so a great way for a surgeon to be able to offer a lower price is to cut corners on patient safety.

Local vs general anesthesia?

One way to cut corners is to operate in a facility that is not designed for general anesthesia. The cost-cutters play into patients' fears by advertising "safe" local anesthesia to avoid the dangers of general anesthesia. All plastic surgeons have the capability to perform breast augmentation under either local anesthesia or general anesthesia. For most patients, the safest option is general anesthesia, which gives you a protected airway. Heavy sedation can slow your breathing down. It is difficult to put an implant under the muscle in an awake patient (you can't numb the muscle), and pain results in high blood pressure, which can increase bleeding during the case.

If you choose a great plastic surgeon who prioritizes patient safety above all else, do you really think he or she would choose general anesthesia if local anesthesia were the safer choice?

What do other patients say?

Now that you've found a well-trained surgeon who doesn't cut corners on safety, you still have more homework to do. How do you know if the surgeon is going to listen to your goals, if you'll receive the care you deserve and how happy most patients are with their results? Although online reviews aren't perfect, nonetheless it is nonetheless worthwhile to check them out. Keep in mind that negative reviews may be legitimate, but they might have been posted by a jealous competitor, a disgruntled former employee or a patient with problems that aren't actually related to the surgery.

On the other hand, a string of raving five-star reviews might have been posted by the surgeon's own office staff. Look for similar wording and sentence structure as a clue that one person posted multiple reviews.

If you find completely different review lengths and writing styles, the reviews are likely to be legitimate. In addition, if a surgeon has a score that's high, but less than five, that is also a good sign that the reviews are legitimate. No one can truly please everyone.

What about the results?

Most plastic surgeons post before-and-after photos in a photo gallery on their website. When looking at the photos, look for consistency between the before photo and the after photo. The lighting, background, camera distance from the patient should all be close to the same. Look for a frontal view and a side view. If you see only a three-quarters view on all photos, there may be a reason; it is easier to hide surgical differences in the left and the right when the patient is partially rotated away from the camera.

Another thing to look at is the natural mismatch in breasts. No breasts are the same. If there are differences in the left and the right, is it because the patients' breasts are different? Or is it because one implant was placed higher or lower than the other? If one breast is naturally larger than the other, did the surgeon improve that by using different sized implants?

If you choose a surgeon who isn't expertly trained or doesn't get great results, if you return for free or low-cost revision, do you think you'll get the result you want? Probably not. If you go to an expert to revise your breast augmentation, the cost will likely be higher (sometimes significantly so) than the cost of an initial breast augmentation. It is usually much more difficult to fix a poorly done breast augmentation than it is to do the first augmentation right.

Contact the office

After you've winnowed down your selection to one or two plastic surgeons, you might want to fill out a contact form on the practice website; attentive, well-trained office staff should get back to you no later than the next business day. The office may offer a virtual consult, in which you can submit photos securely. This can be helpful if you have extreme asymmetry, breast droop or other factors.

When calling the office, note how the staff answers the phone. You may be transferred to a patient coordinator (PC), who should be well-trained to answer questions, including a range of fees. Not all breast augmentations are straight forward. Depending on the shape and tone of your breasts, it's possible that the surgeon may recommend a lift on one or both sides or some other additional procedure. The PC will try to give you an idea of the range of costs so that you are prepared. Financing options are also something you can discuss with the PC.

Your consultation

Look at the big picture. Does the surgeon listen to you and discuss your goals? Do you feel confident that you would get the best care? Though a complication is unlikely, it can happen with any surgery. Is this the surgeon who would respond in the middle of the night or on a weekend?

Choosing your surgeon

Think into the future. If you go to the best surgeon, how are you going to feel? How likely is it you'll achieve your goal? Now, imagine going to the cheapest surgeon. How would you feel if the results aren't so great?

If you prioritize your safety, good results and quality of care above price, it's likely you won't choose the cheapest surgeon you find. But then if you do, chance are you'll get what you pay for.

When choosing a plastic surgeon, be sure to check out the ASPS Find a Plastic Surgeon tool to find an ASPS member surgeon in your area.

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